WRITTEN BY
Justin La Rose, RP, M.Psy is a Registered Psychotherapist (RP, M.Psy) and Clinical Director of The OCD Clinic in Toronto. He has worked in mental health for more than 25 years and has spent over a decade in clinical practice, specializing in treating OCD with Exposure and Response Prevention (ERP).
Clinical examples in this article are composites. Any identifying client details have been changed and anonymized to protect confidentiality.
- 01Liking your therapist isn't enough - you need connection, shared understanding of the problem, and shared understanding of what you're doing about it.
- 02Some problems can be raised and fixed in session - try this first before leaving.
- 03Some mismatches are fundamental - expertise, modality, approach; these can't be fixed with a conversation.
- 04The three-part alliance model is useful - bond, goals, tasks. If you're missing goals and tasks after several sessions, that's a problem.
- 05Staying out of guilt or politeness isn't a virtue - it's just staying.
I fired my therapist. After six sessions. He was smart, thoughtful, and easy to talk to. And it still wasn't right.
People act like leaving a therapist is a big deal - like it's disloyal, or like it means therapy doesn't work. It's neither. Staying in the wrong therapy isn't noble. It's a waste of your time and money, and sometimes it's actively harmful.
Try Harder vs. Get Out
There's a meaningful distinction between problems you should raise and problems that mean you need to leave. Getting this wrong in either direction costs you.
For the fixable problems: a good therapist will welcome direct feedback. Saying "I've been feeling like our sessions are a bit scattered - can we spend more time focusing on X?" is reasonable, and their response to it is useful data. A therapist who becomes defensive or dismissive when you raise a concern is showing you something important about how the rest of the relationship will go.
For the structural problems - competence, modality, fundamental misfit - no amount of honest feedback changes the underlying reality. You can have the most productive meta-conversation in the world with a therapist who doesn't know how to treat OCD. They still don't know how to treat OCD.
The Three-Part Alliance
Research on therapeutic outcomes consistently identifies the therapeutic alliance as one of the strongest predictors of whether therapy works. The alliance has three components - and it's worth understanding all three, because they fail in different ways and require different responses.
Use this framework as a diagnostic. If you have strong bond but weak goals and tasks, try raising it first. Ask directly: "What do you think we're working toward? What would success look like in six months?" If after that conversation goals and tasks remain vague or misaligned - and this persists over several sessions - it's likely a competence or approach issue, not a communication one.
Red Flags
These apply regardless of presenting concern and warrant serious consideration of whether to continue.
If your therapist is doing any of these for OCD - leave. Not because they're a bad person or a bad therapist in general. Because the treatment approach is contraindicated for the condition. Reassurance-giving and insight-seeking both reinforce the OCD cycle rather than breaking it. The longer this continues, the more entrenched the patterns become. See the article on why general talk therapy doesn't work for OCD for a full explanation of what's happening when well-intentioned therapists make OCD worse.
How to Actually Do It
The mechanics of leaving a therapist don't need to be dramatic. This is a professional relationship that isn't working. You end it like an adult.
The most respectful approach: tell them in session. You don't need to prepare a speech. Something direct works: "I've been thinking, and I don't think this is the right fit for me. I'm going to try someone else." You don't owe an exhaustive explanation. You can share your reasoning if you want to - sometimes that feedback is genuinely useful to a practitioner - but you're not obligated to.
If that conversation feels impossible - if having a direct conversation with your therapist about leaving them is itself part of why you're still in the wrong therapy - that's worth noticing. It may be saying something about patterns around conflict, boundary-setting, or disappointing people that are worth working on with the right person. It doesn't mean you have to stay.
An email or a message through their client portal is fine if direct feels like too much. "I've decided to try someone else - thank you for the sessions." Done. That is better than staying in something that isn't working because you can't find a way to say goodbye.
The Question to Ask Before You Start Next Time
One of the most useful things you can do in a first therapy consultation is ask this directly: "If I don't feel like this is working, how should I raise it with you? How do we create space to talk about the work itself?"
A good therapist will answer something like: "Please tell me. I'd rather know than not know. Let's plan to check in every few weeks about whether the work is feeling useful to you. Your feedback is part of what makes this work." They mean it. They've built mechanisms for receiving it. They're comfortable with the possibility that something isn't landing.
A defensive response - dismissal, reassurance that it will work, reframing of the question, discomfort with the premise - is itself your answer. That response tells you something about how the relationship will handle difficulty. And therapy, by definition, involves difficulty. You need someone who can handle it.
For context on what a good first consultation should look and feel like, including what to watch for and what questions to ask, see the article on 4 things to know before starting therapy. For guidance on tracking progress once you've started with someone, see how to know if therapy is working.